Much has appeared in surgical literature in recent years about the advisability of preparatory medical treatment before operations and of proper medical treatment afterward. All that has been written, however, is based on broad general grounds and has no relation whatever to treatment based on homoeopathic principles. Every operation, no matter how necessary, is in itself an injury. Certain remedies have a broad general relationship to injuries. For successful prescribing, the most recent symptoms furnish the most valuable indications for a homoeopathic remedy. During an operation there are four factors to be considered:
The effects of the anaesthesia; the effect of the operation itself; the condition for which the operation is performed and the general state of the patient at the time of the operation. Immediately after the operation, the patient having survived the anaesthesia, the injury from the operation can be considered the most recent symptom. As a general injury-remedy, Arnica is probably the king-pin and it is good practice, as soon as the patient is removed from the operating table, to give him Arnica. It is my custom to put the 30th or the 200th in water and have a teaspoonful given every half hour for three doses and then every two hours for another three doses, unless indications for some other remedy appear. In the majority of cases, the benefit from Arnica will be obvious and frequently it is the only remedy which is needed.
Occasionally it appears to have no effect. However, I never knew it to do harm and it does so much good in the majority of cases that much is gained by giving it early. Where it is not needed and something else is indicated, the symptoms for the other remedy will show themselves as soon as the patient begins to come out from the effects of the anaesthetic. Even though an operation is successful in so far as it relates to the condition for which it was performed, there can frequently be traced directly to the operation remote effects which occur some time afterward. In such a case, one should consider all the remedies which have proved useful in different types of injuries, no matter how long ago the operation had taken place.
If Arnica was not given at the time of the operation, occasionally it will be useful for the long after-effects. Frequently, however, the anaesthesia leaves long after-effects. Obese patients sometimes develop cardiac weakness as one of the remote effects from operations. Chloroform may be useful here, particularly if the operation had to do with the gall-bladder. Where sepsis has been a complicating factor and the patient has never fully recovered, Echinacea is a remedy to be considered. The long after-effects of sepsis from any cause frequently call for Echinacea and of course this means it is one of the most useful of remedies during the active infection.
Arnica is the first remedy to consider in concussion of the head. It is so nearly a specific that one does not have to see the patient who has had a head-injury to prescribe Arnica.
Recently a patient casually mentioned that a friend in another city had been struck on the head by a spring door-stop which came loose and fell on her as she was passing through the door. This had caused miserable suffering with headache and confusion for two weeks and she felt unable to go anywhere. I suggested his sending her a powder of Arnica 200 with his compliments, and he did so. A few days later, he received a letter saying she had received the powder and had taken it at 2 p.m., after which she took a short nap. When she awoke, she felt much better. At dinner she was feeling still better and by bedtime she felt quite well. She was troubled a little during the next three days and then all symptoms cleared up. I have had several just as vivid experiences with Arnica in concussion.
Arnica is a useful remedy to give as a first remedy for a sprain or fracture. If given at once after a fracture, it almost instantly relieves the muscular spasms which often occur and relieves the shock. It is very useful both internally and externally for the effects of a sprain. The sooner it is given, the better.
The various stages of healing of a fractured bone are covered by a group of remedies. Arnica covers the effects of contusion and laceration. Ruta covers well the effects of injury to bone and periosteum and, unless some other remedy is especially indicated, Ruta is the proper one to follow Arnica. After a few more days, Symphytum is apt to be the remedy. Calcarea phos. may come in as well as Symphytum in delayed union.
Recently, in a case of fracture of the surgical neck of the humerus, Arnica, Ruta and Symphytum were obviously helpful in the order mentioned. The ecchymosis, which was extensive, faded rapidly after Symphytum was given. After three weeks, although the pain had gradually diminished, its constancy got on the patients nerves. As soon as she would fall asleep the pain would wake her.
She described it as a gnawing pain, not only in the shoulder of the injured side but also in the shoulder on the other side, as well as in the wrists and joints of both fore-arms and hands. With this was backache at and below the waistline. The pain caused a smouldering rage and indignation. Ledum 200th was given. That night she had the best sleep she had had from the time of the injury and she improved steadily from then on. The pains did not extend from below up nor were they better from cold applications as would be expected for Ledum, but the mental symptoms were perfect for this remedy.
Abscesses can be influenced very markedly if the proper homoeopathic remedy be given. It is my opinion that any abscess can better be taken care of by means of the homoeopathic remedy than by opening it.
When I say by means of “the homoeopathic remedy,” I mean the exact similimum. If the similimum cannot be found, incision may be indicated. In case of an abscessed appendix, one must be very cautious because, unless the remedy is one hundred per cent. perfect, too much danger is involved in not operating, on account of the location of the abscess.
I have had experience with a few cases of abscessed breasts and every patient who has been prescribed for without operation has done better than have those who were incised. Phytolacca is almost a specific for mastitis where abscess is threatening. It is a remedy to keep in mind where abscess has formed and the breast has been incised. Hepar controlled one case of abscessed breast where softening had taken place and the abscess had already begun to point.
The effect of the 200th was obvious at once, the pain being controlled and the tension of the breast becoming much reduced. The inflammation subsided each day and at the end of a week there remained only a small abscess which was released by a slight prick and the discharge of only about a dram of pus. The indications for Hepar were classical. She had chilliness, great sensitiveness to touch, with soreness of the part, and craving for sour lemonade.
In another case, the mother had been obliged to wean her baby because her milk did not agree with the child. She had plenty of milk and more in the right breast than the left. A month later a lump came in the right breast. The lump was a little sensitive to touch and became quite hard. The left breast began to waste. She said that her nipples were very sore and cracked before the baby was weaned. Conium 200 was given. This was followed in five days by a profuse menstruation with a filling out of the left breast and a little milk in both breasts. The swelling and hardness of the right breast were becoming less, the swelling being about two-thirds the size it had been at the beginning.
Two weeks later she began to feel exhausted and became nauseated in the morning, with a diarrhoea which came on as soon as she would rise in the morning; pale yellow and watery and offensive. She became chilly toward evening; her right breast was becoming very painful; Merc. 200 was given. The diarrhoea cleared up at once but the swelling in the breast began to increase, with redness and fluctuation The pain increased and extended into the armpit; chilliness up and down the back, worse at night; couldnt bear to have the breast moved or touched and was kept awake by the pain.
The skin over the breast felt like a burn; evidently, suppuration had taken place and, from the surgical angle, incision was indicated. Instead of that, Merc. 54 M was given and symptomatic relief was dramatic, the pain diminishing within a half-hour. The swelling and soreness gradually lessened; the softened portion concentrated in a small area and later on yielded about one-half tea-spoonful of pus from a slight prick. The induration was gone in about a month and both breasts had come back to normal.
She had a slight cold a month later, which cleared up without medication in two days. Two of her friends had abscessed breasts at the same time; both were operated on; one, three times and neither was well for a month after my patient was completely well.
A recital of the numerous cases of boils which have been successfully prescribed for would be tedious. There is no reason for a homoeopathic prescriber ever to incise a boil.
Empyema of the chest is almost always treated surgically. It is my opinion that many times the pus is evacuated before it should be. I recall two cases which I believe would have recovered if the operation had been deferred. In both cases a remedy was plainly indicated but it was not allowed time to build up the resistance of the patient before the operation was performed.
In empyema of the sinuses, if a remedy be sufficiently closely indicated, operation is seldom needed. Arsenic, Kali bich., Kali iod., and Guaco are useful remedies. Where polypus is or has been present, Teucrium marum verum should be thought of.
Filix mas. This remedy was found by means of the reflexes in the following case: A preparatory school pupil, while boxing, was struck on the side of the neck and knocked down. He got up and tried to resume boxing but, within five minutes, his right leg got weak and he could not walk. A half-hour later he was taken to the hospital and lost all power in his right arm and leg and his speech became affected. Soon after the accident he vomited. Two days later, movement began to come back and, at the end of a fortnight, he could walk a little. Eventually he was able to walk with but a slight limp and, in due time, he entered Harvard.
Four years later, he had so far recovered that a casual observer would not notice any effect from the accident, yet he had not recovered full power in the right side and his right hand was so slowed down that he had difficulty in writing his examination paper. It left also a slight immobility of the face, something like in sleeping-sickness. After Filix mas 200, he became markedly better and has remained much improved. He can write faster, thinks more quickly and his right side is much stronger. This case is remarkable because there had been only a very slight improvement during the four years preceding the Filix mas prescription.
In another case, a physician seventy years of age was struck by an automobile. He wasnt hurt at the time but was greatly shocked, so that he could not work all summer. Two and one-half years later I saw him. He could not remember peoples names or streets, although he could recall them in his mind. Easily tired and difficulty in speech necessitated his giving up all outside activities. Diagnosis was “multiple haemorrhage of the brain followed by oedema.” Filix mas 200 came out through the reflexes and his condition was improved by the remedy. The lasting effect remains to be seen.
In another case, a man of seventy fell in the bathtub, cutting his scalp. After Arnica had taken care of the immediate effect, Filix mas was found through the reflexes and cleared up many of the remaining symptoms. Filix mas has been used as a vermifuge from old Grecian times. When used as a vermifuge, blindness has been caused, due to atrophy of the optic nerve. Its specific relationship to the optic nerve probably indicates its relationship to the base of the brain, where damage is apt to occur from boxing and concussions. It may be a remedy useful in sleeping-sickness.
NEW YORK CITY.
DR. H. A. ROBERTS: It occurred to me that there is a possibility that Dr. Stearns stuck too closely to Arnica in concussions of the brain. Arnica is a good remedy in a good many of those case, but it is not the only remedy in concussion of the brain. He also spoke of Ruta, if it was bruised too much. In automobile accidents many of the concussions of the brain are injury to the bone, a bruised condition of the periosteum of the bone, and I think you will find that Ruta will fit in a good many of those cases better than Arnica.
DR. E. UNDERHILL, JR.: Also Natrum sulph.
DR. H. A. ROBERTS: As I understand it, Natrum sulph. is more for the chronic conditions.
DR. A. H. GRIMMER: Hypericum might be used where the nerve tissues or the spinal nerves are involved.
If there were no idiosyncrasy there would be no homoeopathy. Every individual is susceptible to certain things; is susceptible to sickness, and equally susceptible to cure.–J. T. KENT, M.D.